Hi from Otto and Una in Detroit!

Hi everyone, I am new to posting here but have become familiar with this site on and off over the last year since my boy Otto was first diagnosed. Otto's become hard to regulate so I think it's time I jump on the boards here and see if anyone has any ideas. He was a "honeymooner" and went OTJ a few months after his diagnosis a year ago. At the same time of the FD diagnosis, he was diagnosed with Hyperthyroidism so I started giving him Methimazole in addition to 1U Lantus 2x/day.

Unfortunately at his spring check-up, his bloodwork showed that the Hyperthyroid was not under control anymore, and neither was his blood sugar. So long, remission! Since then, it has been a frustrating ride trying to regulate him, and his insulin dose is now up to 4 U.

In the fall, I did slowly switch him off Fancy Feast Classics to accommodate my other cat's IBD issues. Twiggy is allergic Fancy Feast Classics, but naturally she loves it and is constantly lurking to steal some when my back is turned. I thought I read that Nature's Instinct limited ingredient food was low-carb, so I thought it would make life easier to feed them the same food -- and Twiggy was doing great on the Instinct brand. But recently I made the connection that Otto's BS numbers creeped even higher right around the time I took him off FF. Nature's Instinct carbs are slightly high -- 10-11%. My vet said it should be below 7%, so back to FF it is. We were about to switch off Lantus but my vet recommended waiting to see if going back to FF helped before making the switch, and it seems to be working -- his numbers are more consistent than they've been in 6 months. They're still not dropping into the 100s regularly, but the nadir is more consistent. But morning numbers are very high still. I'm not sure if this is bouncing, or if he really should be on an even higher dose. I will post this in the Lantus forum, but wanted to include all this background in case anyone has had a similar experience...

Anyway, Otto is a cuddly, clumsy sweetheart and I want to do my best for him. Lately he has been much more lethargic, and the neuropathy and arthritis cannot be pleasant. I don't want him to suffer, but he's still eating and using the litterbox as usual and purring whenever he can get laptime, so I still have hope than things can get better. Hoping to learn as much as I can here so I can help him. Thanks for reading!

Sorry to hear abotu Otto's problems, I was using Nature's Instinct limited ingredient food, and had no problem but I was using Turkey that is 7% carbs, I think chicken (also limited ingredient ) is also lower than 10%

Sorry to hear about the lack of remission for Otto.
I don't know if this matters but Oliver, who was just diagnosed, is using the Lantus insulin to in the sola star pen however his numbers were still very high even after the insulin. He's on 3 units. My vet suggested drawing out the insulin into a syringe to see if that helped and it did! His numbers while not great, dropped into the 300's from 400/500's using the pen and needles that fit on the pen. I have no idea why but drawing out the insulin seems to work better.

Maybe you already do this but if you don't, consider trying this method before switching from Lantus as i do hear its a good insulin that has a slower release over a longer period of time into the body.

Just a suggestion.

GOOD LUCK! Oliver has IBD too and cant handle the FF so we use royal canin high fiber and Merrick Purrfect Bistro pate chicken mixed with the high fiber.

I'm sure you'll get lots of good advice in the Lantus forum, ask all you want.

Regarding the using syringes with the pens, that's how most of us use them like they are a mini vial, using syringes allows us to adjust the dose more efficiently ( and not risk skipping the right dose ) since then we can make dose changes in 0.25 increments and decrements that can not be done if you use the one that comes with the pen since that only allows dosing in whole units.

Thanks for the suggestions! That's good to know about the wet foods... Twiggy is allergic to chicken, so it has been tricky finding a grain-free wet food that works.

I have been using syringes with a vial of Lantus. I think the smallest increments on my needles are .5U, but it would be nice to be able to go down to .25U increments. It seems like I am close to the right dose for Otto, but he may need slightly more or less. I will definitely head over to the Lantus forum though!

Thanks for the suggestions! That's good to know about the wet foods... Twiggy is allergic to chicken, so it has been tricky finding a grain-free wet food that works.

I have been using syringes with a vial of Lantus. I think the smallest increments on my needles are .5U, but it would be nice to be able to go down to .25U increments. It seems like I am close to the right dose for Otto, but he may need slightly more or less. I will definitely head over to the Lantus forum though!

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Actually the syringes have marks in half units only but we all eyeball (easier with half markings you position the plunger between marks ) or use a caliper to measure de 0.25 increments or decrements, which is what the protocol recommends and it avoids skipping the right dose.

Looking at your spreadsheet it would appear you have been making dose changes in 1 unit increments which is too big a change and also a little bit too fast, sometimes when this happens you may have passed the good dose and too much insulin can in some cases look like too little.

Re the neuropathy, if you're not already doing so, supplementing the diet with a diabetic-friendly B12 methylcobalamin supplement (e.g. Zobaline) can be a great help. Hopefully the experienced members on the L&L board will be able to suggest things to help improve Otto's regulation and that will help the neuropathy, too.